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Ewbank, Henry Lee, 1893- / Who should pay the doctor bills?
([1936?])

Adopt a system of state medicine,   pp. 26-31 PDF (2.7 MB)


Page 26


26.
                      ADOPT A SYSTEM OF STATE MEDICINE
       Socializod Modicine implies a syston of froo nodical care and practice
sponsored and financed by the state, rmsponsible to the state, and organized,
operated and regulated democratically by tho medical and allied professions.
       State Medicine implies the very sanc thing ns above, except that the
system of medical care and practice would be organized, controllod and ro-
gulated BY the state FOR the rodical and alliod professions.
       The essential difforonco botwoen socializod and state modicino is
               do
that undor tho folnur the control is vested in the madical profession and
under state medicino the control is vested in tho stato. We have many other
forms of socialized service similar to stnte wodicino.   A few of then arc
our police systeri, librarios, educational system, parks, etc.
       Sicknct s Insurance and State Medicine in Other Countrios. State pro-
visions for sickness insurance are found in 36 countries. In 21 countries,
including nost of the loading industrial nations, the plan is compulsory
for
certain groups in the population. In 12 countries sickness insuranco is,.vol-
untary, and in 3 both typos oxist, with different classos of people covered
by each. In some of the countries with voluntary insurance, modical careo
and indemnification for loss of earnings duo to sickness are provided by
govornmont-subsidizod rutual benefit associations.
       The coat of sickness insurance id customarily not by periodic contri-
butions from employers nnd oeployeos, with the stato in some instances contri-
buting directly or assuming sone of the adainistrativo expense.   The chief
emphasis has usually boon upon the payment of cash benofits to cormpensato
for the loss of earnings during illness. This contrasts with riost Azorican
proposals, which provide only for hospitalization and medical care. In most
countries the cash benefit paid ranges from half to two-thirds of the wagos
usually oarnod.  Bonofits are usually linited to 26 weeks.   Bonofits for
dopondents art absont fron some of the plans, pozrissive in others, and con-
pulsory in fiv'. or six of the newer systems.
       The Darlah voluntary system covers a larger proportion of the populaco
than any other plan, compulsory or voluntary, with 45 per cent of tho Vooplo
belonging to recognized funds in 1930. BeJguim had the next most extensive
coverage along voluntary plans, with about 15 per cent. Among compulsory
plans, Great Britain and Germany have tho highost coverage, with 36 and 32
per cent, respectively. If dependents wore included, howover, the Gornan
pordentage would be about 58. In somo countries, including Finland, Italy,
and Spain, the proportion of the population insured is as low as 2 por cont.
       The English plan dates from 1911, with health insurance now compul-
sory for all persons of nodorato incomes.  Fixed cash paymonts aro made
without rogard to former earnings, the rate being reduced after 26 wooks
of continued sickness. Medical attention frou a goneral practitioner , to-
gether with necessary drugs, is provided in the plan, but hospitalization
is not regularly available. Approvod voluntary sicknoss organizations, now
numbering about 1,000, are includod in the plan, and entrusted with the ad-
ministration of benefits. Persons of lort income in many instances obtain
hospitalization through semi-charitable "contributory schemes,"
in which


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